This case was misdiagnosed as benign vertebral body collapse due to osteopenia on the initial report. But after consulting with other doctors, the diffuse abnormality of vertebral body signal on MRI scanning of the spine may suggest bone marrow replacement in hematological pathology.

The patient was later confirmed to have acute myeloid leukemia (AML) by the bone marrow biopsy test.

Musculoskeletal involvement of hematological neoplasm is characterized by bone marrow infiltration. The signal of red marrow replaces the yellow (fatty) signal of bone marrow. These changes are diffuse but can be easily overlooked.

The diffuse low T1W signal with vertebral body collapse is crucial and must be considered carefully. Leukemic bone marrow infiltration is an important differential diagnosis to consider in the situation of vertebra plana.